The Arkansas Experience

While many state Medicaid programs provide some coverage for tobacco-cessation treatments, little is understood about their utilization by Medicaid enrollees. This study specifically examined the utilization of tobacco-cessation treatments under Arkansas Medicaid.

Utilization of tobacco-cessation treatment was assessed using Arkansas Medicaid administrative claims. Specifically, researchers conducted monthly measures and examined the data by: number of pharmacy claims for each covered pharmacotherapy; number of medical calls for counseling services; and number of unique enrollees who received each type of covered tobacco-cessation treatment.

Key Findings:

A total of 12,673 enrolled received some tobacco-cessation treatments between October 1, 2003 and June 30, 2008.

Seventy-seven percent of the enrollees receiving some tobacco-cessation treatment had received pharmacotherapies only.

As coverage expanded, an initial increase of utilization of tobacco-cessation mediations occurred. However, it declined rapidly after three months.

When the smoking cessation aid Varenicline was added, utilization increased, but then decreased quickly after six months.

Counseling services appeared inconsistent with policy changes.

This study shows that low awareness of coverage and low perceived effectiveness may be contributing factors to low utilization of tobacco-cessation treatment. More efforts may be needed to ensure increase utilization of covered tobacco-cessation treatment among Medicaid enrollees.